Charlotte Monro case proves nothing has been learned from Mid Staffs

"We will foster a climate of openness, where staff are supported to
do the right thing and where we put people first at all times," he
declared.
The sad thing is that as hospital trusts are squeezed across the
country, often at the behest of paying huge private finance initiative
(PFI) debts, it seems exactly the opposite is taking place.
Indeed some would argue that what is happening now makes the chances
of another Mid Staffordshire situation all the more likely to recur.
Take the case of Charlotte Monro, a union rep who worked at Whipps Cross hospital in east London for the past 26 years.
An occupational therapist and moving and handling co-ordinator, who
four years ago received a special award, Monro was dismissed on October
30.
The dismissal followed an investigation that began after she
addressed the local Waltham Forest scrutiny committee for Whipps Cross
hospital in east London.
The scrutiny committee is a body made up of local representatives
such as councillors and other concerned individuals charged with
ensuring that local citizens receive the services to which they are
entitled.
Monro addressed the scrutiny committee on June 26 2013, only to be told on July 2 that she was being investigated.
The final dismissal was justified on the grounds of bringing the
Barts Health Trust into disrepute by speaking to the scrutiny committee
and of speaking to staff she worked with prior to the official opening
of a consultation on their service.
The trust also dredged up a charge of failing to disclose previous
convictions relating to protest activities that occurred back in the
1970s. Monro had been involved in protests against apartheid and for
peace in Ireland. This was never regarded as an issue over her previous
26 years of exemplary service.
Upon appeal, the charge of bringing the trust into disrepute was
dropped, while breach of confidentiality and the failure to disclose the
convictions were upheld. Monro is now planning to take her case to an
employment tribunal.
The whole attack on Monro came about after the formation of Barts
Health Trust in 2012. In a reorganisation, Whipps Cross, Newham General
Hospital, St Bartholomews Hospital, the Royal London and Mile End
hospitals were brought together under one body.
Monro tells how when she was dealing with the hospital management at
Whipps Cross there was a good constructive working relationship based on
respect.
This all changed when Barts Health Trust became involved.
"They were clearly out to get me as a union rep," says Monro, who
sees her case as part of a wider effort to destabilise staff generally
by creating an atmosphere of insecurity.
At a time when there have been job losses and posts are being
down-graded, an action like this warns others who might think about
putting their heads above the parapet as to what might happen.
The neutering of union activity in the NHS will also make it less
likely that people will speak out. The union is a source of security and
support to workers, allowing them when necessary to have the confidence
and support to speak out about wrongdoing.
The unions themselves also represent a crucial element of any effective regulation or monitoring process across the NHS.
The role of a union is crucial to any ideas the government may have
of fostering a "climate of openness" when people will not be afraid to
speak out.
What seems certain is that the staff at Barts Health Trust need that
voice. The latest report from the Care Quality Commission on Barts
Health Trust says: "Morale across the trust is low, with staff being
uncertain of their future with the trust and a perception of a closed
culture and bullying.
"Too many members of staff of all levels and across all sites came to
us to express their concerns about being bullied. Many only agreed to
speak with us if they could be anonymous.
"In the 2013 staff survey 32 per cent of staff reported being bullied. The average score for trusts in England was 24 per cent.
"Staff told us they felt stressed at work and said there were not
equal opportunities for career development. This must be addressed
urgently if the trust's vision is to be realised."
Of course in the background of this process are the ongoing deficits caused by PFI.
Big trusts like Barts have been created so that there can be economies of scale, making cuts as and when possible.
These cuts are bound to hit patient care somewhere down the line.
Under section 118 of the care Bill going through Parliament, trust
special administrators (TSAs) will be free to close, merge or privatise
hospitals regardless of doctors, patients or the public.
In the light of the Monro case and other recent developments, maybe
Hunt should go back and reread Robert Francis's report into
Mid-Staffordshire Foundation Health Trust.
Francis referred to a story of "the appalling and unnecessary suffering of hundreds of people.
"They were failed by the system which ignored the warning signs and
put corporate self-interest and cost control ahead of patients and their
safety."
The question then is what has changed. Beyond the rhetoric of
compassion, the market is being allowed to run riot in the NHS to the
cost of staff and patients alike.
The potential whistleblowers who ensured that scandals like Mid
Staffs were exposed are being forced out amid a growing atmosphere of
fear and retribution.